On a cold February evening at the Comanche County Fairgrounds in Lawton, a steady stream of people entered the building and walked between the cattle gates erected on either side herding them to the waiting area.
The 200 or so people gathered at the complex by 10 p.m. werent camped out for a rock concert or a movie release.
They were there for dental fillings, extractions, root canals and the like.
The annual Oklahoma Mission of Mercy provides free dental care and is sponsored by the Oklahoma Dental Association, Delta Dental of Oklahoma Oral Health Foundation and the Oklahoma Dental Foundation.
Justin Gibelyou, 30, and some of his friends made the two-hour trek from Oklahoma City. He showed up the night before and still was No. 170 in line.
An employee for a small landscaping business, Gibelyou said he cannot afford dental or health care. If hes ill, his only option is to go to an emergency room.
If you dont have a job with health or dental benefits, you dont get anything done [medically], he said. I like to work for my money and pay my bills. It costs a lot of pride to come here.
Gibelyou is determined to earn enough to provide for his 4-year-old daughter and to have health care coverage. But that resolve is tempered with skepticism about whether hell ever be able to afford such luxuries especially with his hours being reduced so his employer can get around mandates of the federal Affordable Care Act.
I would hate to have to come down here every year just so I can get dental work, he said. I want to be able to provide for myself.
His predicament, and that of hundreds of thousands of his fellow Oklahomans, has been the subject of intense scrutiny. While Gov. Mary Fallins decision not to expand the states Medicaid program for individuals making up to 130 percent of the poverty level has been both praised and pilloried, she has made health issues a key part of her legislative agenda.
The bottom line is Republicans, Democrats and nonpartisans all agree that Oklahoma health care desperately needs improvement.
The data on Oklahomans health paints a bleak picture.
According to the United Health Foundation, the state is ranked 43rd in the nation in terms of overall health an improvement from 49th a couple of years ago, according to Terry Cline, commissioner of the state Department of Health.
Obesity rates climbed from 11 percent in 1990 to more than 30 percent in 2010, with Oklahoma ranking 45th in terms of sedentary lifestyle. It is 47th for tobacco use, 48th for cardiovascular disease deaths, 49th for the number of primary care physicians per 100,000 people and 39th for infant mortality rates.
Meanwhile, according to the Oklahoma Dental Association, the state is dead last in the nation for the percentage of adults who visit a dentist.
While the country as a whole has seen an increase in life expectancy over the past two decades, Oklahoma still lags behind.
national life expectancy for a woman is 81; for a man, its 76. But in
Oklahoma, Cline said, women have a life expectancy of 78, while the age
is 73 for men.
concerning, life expectancy in the state is declining for women.
Nationally over the past 20 years, life expectancy increased by two
years for women and four years for men. In Oklahoma, mens life
expectancy improved by only one year. For women, it actually went down
by a fraction.
the first time in history, were seeing a decline in life expectancy for
one of these groups, and its women in the state of Oklahoma, Cline
said. That is a significant wake-up call.
Looking for cures
said the state is looking at ways to form its own health plan with
three goals: improve health outcomes; slow or reduce the growth of
health care costs; and expand access to health insurance.
believe we need something specific to the needs of Oklahoma, Cline
said. The objectives out lined arent accomplished simply by expanding
[Medicaid]. We currently have huge access issues in the state, and
expanding the system doesnt necessarily address those. Our current
system, I think everyone is in agreement, is flawed.
For House Speaker T.W. Shannon,
R-Lawton, access to primary health providers, especially in rural
areas, is a chief concern. Like Fallin, however, Shannon contends the
state cant afford to expand Medicaid.
no way we can rely on the federal government to continue to keep the
commitments its already made, much less new commitments, he said.
state Legislature is working to get more primary care physicians to
rural areas by encouraging doctors to spend their residencies in such
underserved regions, said state Senate President Pro Tempore Brian
If we get Oklahomans and
get them in [medical] school, theres a better chance theyre going to
stay in Oklahoma and practice here, too, Bingman said.
the state is involved in a campaign to lower its infant mortality rate
by educating mothers on issues ranging from safe infant sleeping methods
to the effects of smoking while pregnant.
successfully has implemented a voluntary program for hospitals to lower
nonmedically necessary, early-induced deliveries and cesarean sections,
since a baby is more likely to experience health problems if born
before 39 weeks gestation. Most birthing hospitals in the state has
signed on to the initiative.
said local control of smoking is also vital to strengthening public
health. Oklahoma is one of only two states that pre-empts counties and
municipalities from enacting tobacco ordinances tougher than what state
law has established. An effort to repeal that pre-emption was killed by a
Senate committee this legislative session. Fallin, who had made repeal
part of her agenda, responded by launching an initiative petition to
bring it to a statewide ballot.
is an archaic, backwards, medieval-times mentality that does not allow
communities to protect their citizens from the No. 1 preventable cause
of death, which is tobacco, Cline said. These communities are telling
us, We want the right to protect our citizens. And why should our
rights be denied us by a group of people in Oklahoma City at the
Cline credits the Oklahoma Health Care Authority for seeking to bolster
dental coverage in the state, he said more needs to be done.
with that improved coverage, its very obvious theres a huge need in
our state, Cline said, pointing to the nearly 1,800 people who visited
the Mission of Mercy last month. Its the same story over and over: You
have people camping out the day before to get in there.
noon, that arena had become a living thing itself. Dentists, dental
students, assistants, patients and a legion of volunteers bustled about,
efficiently moving the patients through.
Fain sat waiting for her turn. She said she had sought help in Oklahoma
City, her hometown, but couldnt get into a clinic.
Her dental problems and missing teeth have impacted her employability and feelings of self-worth.
Its hard to get work, she said. I wouldnt hire me.